Adenomyoma and leiomyoma: differential diagnosis with transvaginal sonography.
OBJECTIVE
The purpose of this study was to evaluate the capability of transvaginal sonography to differentiate adenomyomas from leiomyomas.


METHODS
Two hundred six patients scheduled for surgery for symptomatic uterine masses underwent preoperative transvaginal sonography. Sonographic findings were compared with pathologic findings. Pathologic findings showed that 111 patients had leiomyomas, 48 had diffuse adenomyosis, 31 had adenomyomas, and 4 had leiomyosarcomas.


RESULTS
For the diagnosis of adenomyoma, transvaginal sonography demonstrated a sensitivity of 82.0%, specificity of 88.3%, positive predictive value of 84.6%, and negative predictive value of 87.5% compared with a sensitivity of 95.1%, specificity of 82.0%, positive predictive value of 90.7%, and negative predictive value of 85.7% for the diagnosis of leiomyoma. Two sonographic characteristics, lesion margin (p = 0.0001) and lacunae (p = 0.0001), allowed the differentiation of adenomyoma from leiomyoma.


CONCLUSIONS
Transvaginal sonography is an effective procedure for the preoperative differentiation of adenomyoma from leiomyoma. If the status of the lesion's margins and the presence or absence of hypoechoic lacunae were selected for analysis, leiomyomas could be correctly diagnosed with transvaginal sonography in 95% of cases.
Botsis
D
D
2nd Department of Obstetrics and Gynecology, University of Athens, Areteion Hospital, Greece.
Kassanos
D
D
Antoniou
G
G
Pyrgiotis
E
E
Karakitsos
P
P
Kalogirou
D
D
D018194:Adenomyoma / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000000981:diagnostic imaging*; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging*